Härtel Christoph, König Inke, Köster Stefan, Kattner Evelyn, Kuhls Eckhardt, Küster Helmut, Möller Jens, Müller Dirk, Kribs Angela, Segerer Hugo, Wieg Christian, Herting Egbert, Göpel Wolfgang
Department of Pediatrics, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
Pediatrics. 2006 Aug;118(2):683-9. doi: 10.1542/peds.2005-2670.
Recent investigations have reported an influence of thrombophilic mutations and antithrombotic risk factors with development of intraventricular hemorrhage. It was our objective for this study to investigate the impact of genetic polymorphisms of hemostasis genes on the primary outcome measures of sepsis, bronchopulmonary dysplasia, intraventricular hemorrhage, and periventricular leukomalacia in a large cohort of very low birth weight infants.
There were 586 very low birth weight infants enrolled prospectively in a multicenter trial between September 2003 and July 2005, and an additional 595 very low birth weight infants, who had been recruited in a previous prospective trial, were studied. DNA samples were taken by buccal swab, and genotypes of factor V Leiden mutation, prothrombin G20210A mutation, the factor VII-323 del/ins polymorphism, and the factor XIII-Val34Leu polymorphisms were determined by polymerase chain reaction and restriction enzyme digestion.
In contrast to data published previously, the frequency of intraventricular hemorrhage or periventricular leukomalacia was not significantly influenced by any of the genetic variants tested. Carriers of the factor XIII-Val34Leu polymorphism, however, had a higher sepsis rate and a longer period of hospital care compared with noncarriers. The factor VII-323 del/ins polymorphism was found to be a potential protective factor against bronchopulmonary dysplasia.
We could not confirm previously reported associations of hemostasis gene variants and development of intraventricular hemorrhage in very low birth weight infants. To better understand gene-disease associations in very low birth weight infants, the prospective development of large-scale cohorts with well-defined phenotypes and corresponding DNA samples is essential.
近期研究报告称,血栓形成倾向突变和抗血栓形成风险因素会影响脑室内出血的发生。本研究的目的是调查止血基因的基因多态性对一大批极低出生体重儿败血症、支气管肺发育不良、脑室内出血和脑室周围白质软化等主要结局指标的影响。
2003年9月至2005年7月期间,有586名极低出生体重儿前瞻性地纳入了一项多中心试验,另外还对在之前一项前瞻性试验中招募的595名极低出生体重儿进行了研究。通过颊拭子采集DNA样本,采用聚合酶链反应和限制性酶切法测定因子V莱顿突变、凝血酶原G20210A突变、因子VII - 323 del/ins多态性以及因子XIII - Val34Leu多态性的基因型。
与之前发表的数据相反,所检测的任何基因变异均未对脑室内出血或脑室周围白质软化的发生率产生显著影响。然而,与非携带者相比,因子XIII - Val34Leu多态性的携带者败血症发生率更高,住院时间更长。发现因子VII - 323 del/ins多态性是预防支气管肺发育不良的一个潜在保护因素。
我们无法证实之前报道的极低出生体重儿止血基因变异与脑室内出血发生之间的关联。为了更好地理解极低出生体重儿的基因 - 疾病关联,前瞻性地建立具有明确表型和相应DNA样本的大规模队列至关重要。